经脐单部位腹腔镜治疗小儿隐睾的疗效分析

目的 探讨经脐单部位腹腔镜手术治疗小儿隐睾的临床疗效.方法 回顾性分析2011年1月至2014年6月35例行经脐单部位腹腔镜手术隐睾患儿(单部位腹腔镜组)和同期47例行传统腹腔镜手术隐睾患儿(传统腹腔镜组)的临床资料.比较两组患儿手术时间、术中估计失血量、术后住院时间、术后疼痛程度(VAS评分)、患儿对切口瘢痕满意程度等指标.结果 两组均成功完成手术.单部位腹腔镜组平均手术时间(44.89±4.16)min长于传统腹腔镜组(40.85±3.09) min,差异有统计学意义(P＜0.01);术后8h疼痛评分(3.11±0.93)分低于传统腹腔镜组(4.09±0.88)分,差异有统计学意义(P＜0.01);术后止痛药物应用率(11.43％)低于传统腹腔镜组(29.79％),差异有统计学意义(P＜0.05);术后患儿对切口的满意度评分(4.60±0.81)分高于传统腹腔镜组(3.96±0.98)分,差异有统计学意义(P＜0.05).两组术中出血量、术后24 h疼痛评分及术后住院时间比较,差异均无统计学意义(P＞0.05).两组术后随访10～16个月,平均13个月,均无睾丸萎缩或回缩,无腹股沟斜疝或脐疝发生.结论 经脐单部位腹腔镜手术治疗小儿隐睾安全、有效,且术后疼痛轻,腹部瘢痕不明显,为小儿隐睾的治疗提供了一种新的选择.

Efficacy of single-site umbilical laparoscopy in the treatment for children with cryptorchidism

Objective To evaluate the clinical efficacy of single-site umbilical laparoscopy for children with cryptorchidism.Methods Retrospective analyses were conducted for the clinical data of 82 children with cryptorchidism from January 2011 to June 2014.They were divided into single-site laparoscopy group (SLG,n =35) and conventional laparoscopy group (CLG,n =47).The parameters of operative duration,intraoperative blood loss,postoperative hospital stay,postoperative pain,level of patient satisfaction with incision scar were compared between two groups.Results All operations were successful in both groups.Operative duration was longer in SLG than that in CLG (44.89 ± 4.16) vs (40.85 ± 3.09) min,P＜0.01];pain scores (8 h post-operation) were lower in SLG than those in CLG (3.11 ± 0.93) vs (4.09 ± 0.88),P＜0.01];utilization rate of anodyne was lower in SLG than that in CLG (11.43％ vs 29.79％,P＜0.05);level of patient satisfaction with incision scar was higher in SLG than that in CLG (4.60-± 0.81) vs (3.96 ± 0.98),P＜0.05].Intraoperative blood loss,pain scores (24 h post-operation) and postoperative hospital stay were not different between two groups (P＞0.05).During a mean follow-up period of 13 (10-16) months,there was no instance of testicular atrophy or ascent or hernia.Conclusions Single-site umbilical laparoscopy is both safe and efficacious for cryptorchidism in children.It offers the advantages of lesser postoperative pain and minimal abdominal scar.